Reporting of Telehealth Implementation in Cystic Fibrosis: Scoping Review Using a Novel Theory-Based Evaluation Lens

Many inductive reviews exploring telehealth and its application in health care have identified missing or inconsistently reported implementation data, calling for a standardized approach to telehealth research.

Using cystic fibrosis (CF) as a case exemplar, this study evaluated the adherence of telehealth research to standardized reporting frameworks through a theory-based evaluation lens to assess implementation reporting quality and identify knowledge gaps and strengths across the literature.

We conducted an updated systematic review of the PubMed, Scopus, and Web of Science databases using a novel deductive approach to identify relevant scientific papers available in English and focusing on the delivery of telehealth interventions to CF populations as part of or alongside routine CF care. Two relevant reporting checklists were identified in the Equator Network database (Guidelines and Checklist for the Reporting on Digital Health Implementations [iCHECK-DH] and Template for Intervention Description and Replication for Telehealth [TIDiER-telehealth]) to extract data from the papers. Each checklist category was described as being "fully reported" (score=2), "partially reported" (score=1), and "did not report" (score=0) for each paper. An overall score was calculated for adherence to the checklists.

In total, 98 studies published between 2006 and May 2025 were included in this review, with the majority appearing during the COVID-19 pandemic (2021-2022). Most studies were conducted in a single country, predominantly the United States, Australia, and the United Kingdom, and were published in medical journals. Telehealth was variably described, with video call-based models in combination with remote monitoring being most common. The median score was 22/40 (range 11-29, 55.0% adherent) for iCHECK and 15/24 (range 6-23, 62.5% adherent) for TIDiER, demonstrating moderate overall reporting quality. For iCHECK, ≥50% of studies fully reported 6/20 categories, partially reported 9/20 categories, and did not report 3/20 categories. For TIDiER, ≥50% of studies fully reported 4/12 categories, partially reported 6/12 categories, and did not report 1/12 categories, indicating persistent gaps in intervention description despite improved partial reporting.

Key areas, such as justification for telehealth, target populations, and outcomes, are well documented, offering valuable insights into the rationale for and outcomes associated with telehealth. However, implementation processes remain underreported, partly due to the more recent adoption of frameworks like iCHECK and TIDiER. The clinical implications of the current evidence limit the implementation of telehealth in terms of the ability to assess feasibility and readiness for adoption; understand financial implications and plan sustainably; ensure patient safety, data protection, and equity; interpret outcome data in context; and share, replicate, or scale evidence-based models of care. Strengthening the commitment to standardized telehealth reporting will ultimately support clinical decision-making and improve the effective and equitable integration of telehealth into care.